Decisive inaction on bird flu

It's decided then. Definitely. They'll decide by the end of the summer. Maybe.

The US pandemic influenza plan, in the works for five years and in only in draft form since last August will be completed in final form "by the end of the summer."

Marcia Cross, the [the Government Accountability Office's] director for health care, told lawmakers that federal officials have yet to determine what role the federal government will take in purchasing supplies of vaccine against bird flu and other flu strains. The government has also not cemented which population groups would be priorities for emergency vaccination in the event of an outbreak or finalized plans for possible quarantines or travel restrictions.

The delay has left state health departments unable to properly plan for flu emergencies, she says. (Via WebMD)

No plan. How about a drug stockpile for an emergency? CDC Director Dr. Julie Gerberding explained the Administration's failure to establish an adequate stockpile of antiviral drugs this way:

Officials said they are moving to purchase more drugs for the stockpile but defended their decision not to engage in a massive buildup. While the drug can lessen disease severity if taken with 48 hours of the start of symptoms, no studies have shown that it improves patients' chances of surviving bird flu, Gerberding says.

"Making enormous purchases in stockpiling may be a premature decision," she says. "The studies simply haven't been done." (WebMD)

That's interesting. Because there is excellent data to show that antivirals like oseltamivir are effective if taken prophylactically. Doesn't preventing the disease improve your chances of surviving it? I guess one of us skipped that class in Epidemiology 101. Of course, maybe the evidence doesn't rise to the level of the protective effect of inspecting shoes at airports, but hey . . .

Vaccine?

An experimental bird flu vaccine is undergoing safety and effectiveness testing at the National Institutes of Health. Early safety data are expected this summer, [NIAID Director Tony] Fauci says.

That's great. About time. Except . . . the vaccine they are safety testing doesn't contain an adjuvant, an additive which could extend the vaccine supply many fold. They're going to test adjuvanted vaccine at a later time. End of the summer maybe? Of what year?